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Guardianship Questionnaire (Relative Cases) - California
| Guardianship Questionnaire (Relative Cases) Form. This is a California form and can be used in Civil Kings Local County . |
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(local form) In the Superior Court of the State of California FOR COURT USE ONLY (RECEIVED ON): In and for the County of Kings GUARDIANSHIP QUESTIONNAIRE (For relative cases) Case Number: Hearing date (if applicable): Instructions to Petitioner: The questionnaire is important in introducing you and your situation to the investigator handling your case. Attach additional pages, as needed. In order to begin the investigation ordered by the Court, each petitioner must complete a questionnaire and return it, along with your completed investigation packet to either: KINGS COUNTY SUPERIOR COURT 1426 South Drive Hanford, CA 93230 Attention: Probate Clerk OR KINGS COUNTY SUPERIOR COURT 449 "C" Street Lemoore, CA 93245 Attn: Civil Investigator Name of Child (1): Address of Child (1): Name of Child (2): Address of Child (2): Name of Child (3): Address of Child (3): Name of Child (4): Address of Child (4): DOB: DOB: DOB: DOB: Proposed Guardian Information Name of Proposed Guardian: Other Names Used: Relationship to Child: Age: Address: Home Phone: Sex: Driver's License No. Height: Weight: DOB: Place of Birth: City: Business Phone: Eyes: Social Security No. Hair: State: Zip: Guardianship Questionnaire (relative cases) local form revised on 04-08-2011 Page 1 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Provide previous residential history (Past 10 years): Natural Mother of Child Name: Current or last known Address: City: Height: Driver's License No. DOB: Place of Birth: Weight: State: Eyes: Social Security No. Zip: Phone: Hair: Date and location of last contact with child: Natural Father of Child (1) Name: Current or last known Address: City: Height: Driver's License No. DOB: Place of Birth: Weight: State: Eyes: Social Security No. Zip: Phone: Hair: Date and location of last contact with child: Natural Father of Child (2) Name: Current or last known Address: City: Height: Driver's License No. DOB: Place of Birth: Weight: State: Eyes: Social Security No. Zip: Phone: Hair: Date and location of last contact with child: Natural Father of Child (3) Name: Current or last known Address: City: Height: Driver's License No. DOB: Place of Birth: Weight: State: Eyes: Social Security No. Zip: Phone: Hair: Date and location of last contact with child: Guardianship Questionnaire (relative cases) local form revised on 04-08-2011 Page 2 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Natural Father of Child (4) Name: Current or last known Address: City: Height: Driver's License No. DOB: Place of Birth: Weight: State: Eyes: Social Security No. Zip: Phone: Hair: Date and location of last contact with child: Other Children of Mother or Father Name: Age: DOB: Living with whom? Employment Data of Proposed Guardian Occupation: If unemployed, what are your employment plans? Present or last employer: Address: Work days & hours: Employment began: Ended: Previous Employer: Employment began: Ended: Marital History of Proposed Guardian (List all marriages) Name (To Whom) Date & Place How Terminated (Divorce, Death) Date Separated Final Was there ever any domestic violence in any of the marriages? If yes, please explain: Yes No Guardianship Questionnaire (relative cases) local form revised on 04-08-2011 Page 3 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Name (list all) Proposed Guardian's Children (Include adult children, first & last names) Age DOB Children's Address (If different than parent) Do any of the Proposed Guardian's children have criminal histories or involvement with Child Protective Services? Yes No If yes, please explain: High School graduate? If not, grade last attended: Reason for leaving: College or University Attended Education Year: Name of school: Degree/Units Major Health Insurance: Present health status: Good Fair Poor If fair or poor, please explain: Have you ever had a substance abuse problem with any of the following? Alcohol Yes No Drugs Yes No If yes to any of the above, please explain: List all medications currently taking: Guardianship Questionnaire (relative cases) local form revised on 04-08-2011 Page 4 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Criminal Record Have charges ever been filed against you for any crime other than a traffic violation? Yes No List Arrests If yes, please specify: Where When Charge Are you currently on Probation? Are you currently on Parole? Officer's Name: Agent's Name: Have you ever been involved with Child Protective Services? Yes No If yes, please explain: Family Functioning of Proposed Guardian What types of activities do you participate in as a family? How many bedrooms? Housing House Apartment Plans for Child Care (If needed) Address: Phone: Hours Address: Phone: Hours DOB Others in Household Relation to Driver's License Guardian Number Social Security Number Name: Relationship to child: Name: Relationship to child: Name Guardianship Questionnaire (relative cases) local form revised on 04-08-2011 Page 5 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Minor (1) History Professional Practitioners (Medical doctors, psychiatrists, psychologists, counselors, social workers, etc.) Name & Title Last Contact Address Phone Minor's present health status: If fair or poor, please explain: Special health problems: Good Fair Poor Minor (2) History Professional Practitioners (Medical doctors, psychiatrists, psychologists, counselors, social workers, etc.) Name & Title Last Contact Address Phone Minor's present health status: If fair or poor, please explain: Special health problems: Good Fair Poor Minor (3) History Professional Practitioners (Medical doctors, psychiatrists, psychologists, counselors, social workers, etc.) Name & Title Last Contact Address Phone Minor's present health status: If fair or poor, please explain: Special health problems: Good Fair Poor Guardianship Questionnaire (relative cases) local form revised on 04-08-2011 Page 6 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Minor (4) History Professional Practitioners (Medical doctors, psychiatrists, psychologists, counselors, social workers, etc.) Name & Title Last Contact Address Phone Minor's present health status: If fair or poor, please explain: Special health problems: Good Fair Poor School of Child (1) Is the minor currently enrolled in school? Yes No If yes, where? What grade? Submit copy of most recent report card. Does the minor participate in extracurricular activities? If yes, what activities? Yes No School of Child (2) Is the minor currently enrol
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